Thoughts from my little corner of the world.

A New Low

Most of you know that I am an EMT. You won’t find me riding around in an ambulance or even working in the ER – instead I volunteer at events on behalf of our local fire department. I love to help people and have always been interested in medicine.

I am blown away at a news story out of Bakersfield today. And 87 year-old-woman living in an independent living facility (Glenwood Gardens) collapsed in the dining room on February 26th. A woman called 911 and asked for paramedics to be sent to help – and then proceeds to tell the dispatcher that she is a nurse, but will not do CPR. The dispatcher spends seven minutes and sixteen seconds doing everything in her power to try to convince the nurse to help the ailing woman (or to find someone who will). Apparently, the home has a policy that says “in the event of a health emergency at this independent living community, our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives.”

Here’s the thing. I understand that the general public is terrified of getting sued. And that they worry about not doing CPR right, about breaking bones, about disease, about blood and guts and vomit. What I am most appalled at is the fact that this woman is a NURSE. She had a duty to act. She should be stripped of her license to practice. My God, there are stories of kids doing CPR that end up saving lives. Would this have helped this woman? I would guess probably not – in fact, more times than not CPR isn’t successful. The point is that you give them a fighting chance. To stand by and literally watch a woman die in front of you is incomprehensible. Despicable. Deplorable. I can’t understand how anyone can just stand there and not even try.

I beg you, if you don’t already know CPR, please learn. Over the years they’ve actually made CPR easier and hands only (for those of you afraid of cooties). Check out the American Heart Association or American Red Cross for classes in your area. Does it always work? Absolutely not. If it’s your kid, mother, husband, or grandma, do you want to give them a chance? ABSOLUTELY!

Here is the partial 911 call that was released to the public – see if you’re as enraged as I am (I am picturing my 80-something year old Oma who is currently living in an assisted living home).

Dispatcher: This woman’s not breathing enough. She’s gonna die if we don’t get this started. Do you understand?

Caller: I understand. I am a nurse. But I cannot have our other citizens, who don’t know CPR, do it. We’re in a dining room.

Dispatcher: I will instruct them. Is there anyone there?

Caller: I cannot do that.

Dispatcher: OK, is there anyone there who is willing to help this patient?

Caller: I am, but…

Dispatcher: OK great, then I’ll walk you through it all. EMS takes the liability for this, Colleen. I’m happy to … OK? This is EMS protocol. OK?

Caller: (To someone off the phone) I don’t know where he is. She’s yelling at me to have one of our other residents perform CPR. And I’m not gonna do that, and make that call.

Dispatcher: Are we just gonna let this lady die?

Caller: Well that’s why we’re calling 911.

Dispatcher: We can’t wait. She can’t wait right now. She is stopping breathing. She can’t wait for them to get there.

Caller: She’s taken three breaths.

Dispatcher: It’s not enough. We need to get CPR started.

Caller: (Chatter in background) He’s saying we don’t. You can talk to my boss, and I don’t know what to say.

Caller: When will the fire department be here? When will the ambulance …

Dispatcher: OK, well then if you get anybody, any stranger that happens to walk by that’s willing to help. I understand if your boss is telling you can’t do it. But if there’s any human being… Is there anyone that’s willing to help this lady and not let her die?

Caller: Um, not at this time.

Dispatcher: (To someone off phone) They won’t. They won’t touch her at all. I can’t get anyone to touch her at all.

Caller: We have residents that are …

Dispatcher: Any guests? Any guests that are there that are willing to help?

Caller: No, I don’t have any.

Dispatcher: Is there a gardener, any staff? Anybody who doesn’t work for you anywhere? Can we flag someone down in the street and get them to help this lady… Can we flag a stranger down? I bet a stranger will help her. I’m pretty good at talking them into it. If you can flag a stranger down I will help. I will tell them how to help her.

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3 thoughts on “A New Low”

I do understand your reaction. As providers of care, we are trained to assist. However, CPR is not appropriate if against the patient’s wishes, and according to the woman’s daughter, she desired no heroic measures. The 911 caller happened coincidentally to be a nurse, but she was not a nurse at that facility, which was only licensed for Independent Living. She would have been covered legally by Good Samaritan laws if she had intervened, but it’s also possible she was fully aware of the woman’s preference to be allowed to die.

Of course it’s also the media’s job to fire people up by spinning partial facts. We all got misled by this story. More than CPR, this patient needed an AED, and possibly oxygen. Neither would have likely helped an 87 year-old post myocardial infarction, and I wonder about the morality of bankrupting your loved ones in trade for three months of non-responsive “life” in the ICU. Despite our training to intervene, we must accept that death is natural, and at some point inevitable. We should concentrate more on making that process as pain-free as possible.

You make some very valid points (I definitely agree she needed oxygen and an AED and that more than likely she wouldn’t have survived anyway, but I also know that if she really wanted no heroic measures she needed to have a DNR on file – maybe that’s the discussion we need to have – making people more aware of their options and the necessity of having them in writing.

Thanks for your reply. Since posting I found out the post-mortem was that the woman had a thrombolytic (ischemic) stroke. It was a non-cardiac event, so CPR would have done nothing, except maybe kill her quicker via rib fractures or aspiration. I totally agree with you about the DNR, which she could have had in her purse, and the facility’s policy about intervention in emergencies could be clarified.